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AmeriHealth New Jersey waives inpatient COVID-19 cost-sharing

Suspends prior authorizations for acute inpatient admissions, post-acute transfers

Anthony Vecchione//April 6, 2020//

AmeriHealth New Jersey waives inpatient COVID-19 cost-sharing

Suspends prior authorizations for acute inpatient admissions, post-acute transfers

Anthony Vecchione//April 6, 2020//

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Cranbury-based AmeriHealth New Jersey announced April 3, it will waive member cost-sharing for in-network, inpatient, acute care treatment for COVID-19.

This means members will pay no copay, co-insurance or deductible in this scenario. The company will also waive cost-sharing for emergency department visits when members are admitted to the hospital under these same conditions. These changes are effective March 30, 2020 and extend through May 31, 2020.

The changes are for fully-insured business customers. Self-insured customers can opt-out of coverage.

In an effort to assist physicians and health care facilities during this crisis, AmeriHealth announced it would temporarily suspend prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through April 30.

In addition, prior authorization requirements are temporarily suspended for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required.

This includes suspending prior authorization requirements for in-network transportation from an acute inpatient facility to a post-acute facility.

These steps are intended to facilitate and reduce administrative processes for the placement of COVID-19 patients to the most appropriate care settings.

AmeriHealth said it would continue to evaluate these decisions and others as the COVID-19 situation evolves and serve customers through several initiatives designed to assist our members, including numerous coverage policy changes, outreach by registered nurse health coaches, digital resources, and more.